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MERTON COUNCIL Merton Carers Strategy 2021-2026 Making Life Better for Carers merton.gov.uk
2 Merton Carers Strategy 2021-26
Merton Carers Strategy 2021-26 3
Contents
Foreword ...................................................................... 4
Carer Foreword ............................................................ 5
1 | Welcome ............................................................ 6
2 | Introduction..........................................................8
3 | A Vision for Carers in Merton.............................9
4 | Overview of Priorities.........................................10
5 | The Merton Story...............................................11
6 | Caring in Merton................................................13
7 | Policy Context....................................................14
8 | Priority One:
Identification, Recognition, and Contribution.........15
9 | Priority Two:
Health and Wellbeing of Carers.............................19
10 | Priority Three:
Realise and Release Potential...............................23
11 | Priority Four: 13 | Appendix 1:
A Life Alongside Caring.........................................27 Organisations that provide information, advice, and
support to carers in Merton..................................32
12 | Next Steps.........................................................31
14 | Appendix 2:
Members of the Carers Strategy Task Group........34
15 | Appendix 3:
Policy Context......................................................35
16 | Appendix 4:
Local Strategic Link Summaries............................36
17 | Appendix 5:
Carer Definitions...................................................38
4 Merton Carers Strategy 2021-26
Foreword
Councillor Stephen Alambritis, Cabinet Member
for Adult Social Care and Health
As the Cabinet Carers UK estimates that as of 2019 there are as
Member responsible many as 8.8 million adult carers in the UK which
for Adult Social means that 1 in 8 adults in the UK are carers. These
Care and Health, figures suggest that there are roughly 20,000 carers
I understand the in Merton. Yet, many of these people are unknown
essential role that to the authorities and local research has shown that
carers play in our a significant number do not know what support is
community and the available to them. Carers UK estimates that by 2037,
incredible support the number of informal carers across the UK needed
they provide, and I would like to thank them. could rise by 40 per cent (2.6 million people) taking
Carers not only provide care and support to the total number of people providing informal care to
loved ones with varying levels of need, they 9 million.
often do this without much recognition of the
commitments they make and the impact this has It is really positive to see the collaboration of all key
on their wellbeing. partners working together with carers to produce
this strategy. Caring can lead to greater connection
This has been a challenging time for everyone but with loved ones and when supported by appropriate
especially for carers. We are aware of the impact support and services can have a positive impact
that changes in their usual support has had on on a carer’s wellbeing. This strategy highlights the
many carers. We know that carers have reported excellent support that is available to carers across
feeling worried about the future, have experienced the borough (organisations that provide support
isolation and have felt the strain that their caring role are listed in Appendix 1) and carers who use these
has had on their own physical health and wellbeing. services tell us what a difference they make to their
Therefore, we have acknowledged the impact of the lives. However, we know we need to do more,
Covid-19 Pandemic on carers in this Strategy. especially at this difficult time. We also need to
provide a broader range of options to support carers
To achieve the vision of the Carers Strategy, in throughout their caring journey.
the context of sustained financial challenges, our
collective aim is to reengineer the investment and Therefore, this strategy expresses our commitment
resources in services that support carers. We aim to improve the services and support on offer to
to put carers at the centre of this work and to place carers in the borough, and ensure that professionals
greater emphasis on working with all our partners across the health and social care sector recognise
to maximise resources as well as seek additional the work carers do and value their expertise and
funding opportunities that widen the local offer to experience of providing care for a loved one. I
carers. look forward to seeing the actions in this strategy
implemented over the next five years and to Merton
becoming a carer friendly borough.
Merton Carers Strategy 2021-26 5
Carer Foreword
Sally Burns, family carer and member of Carers
Strategy Task Group
Since work started Our situations and needs as carers vary enormously
on the new Carers’ – and we always need to be treated as individuals.
Strategy nearly two But there are also some very clear themes that
years ago so much came out of the engagement and these are reflected
has changed. We are in what we want to see happen next – a range of
now living through a actions that should help to improve our lives in
worldwide pandemic different ways. Making sure carers get assessments
and all the disruption and know about the help they can get, don’t have to
and sadness it’s struggle with unnecessary bureaucracy and can get
brought with it, and trying to work out what the help to plan for the future are just some examples. In
future holds for us. a time of uncertainty, I think it’s even more important
that we as carers help plan services that will support
Two things are certain – those of us who were us in future. And I’m glad to say that carers will be
already caring for someone have had to work even part of the group that will be set up to put these
harder since March last year. At the same time, the action plans into practice.
number of people who find themselves thrust into a
caring role has gone up dramatically. So what does
this army of carers want to see happen locally?
I have to admit my initial reaction on hearing there
was going to be a new carers’ strategy for Merton
was rather cynical – I’ve seen past efforts achieve
very little! But what’s been so good about this
exercise was getting carers involved right from the
start – and really listening to what we’re saying.
It’s also been very encouraging to see people
from the council, CCG and many voluntary sector
organisations working together on it, as it will
definitely need coordinated action to make progress.
6 Merton Carers Strategy 2021-26
Merton Carers Strategy 2021-26 7
1 | Welcome
1.1 1.3
This strategy has been co-produced with a number To implement and monitor this Strategy, an
of organisations and carers to make sure that views Implementation Board will be established and state
and expertise from across the borough shaped this each year (starting 2021), a short implementation
strategy. plan will be developed which will outline eight to
twelve key priority actions and outcomes for each
1.2 year. Our aim is to achieve these actions, which over
Over 200 carers and 50 professionals from a range time will allow us to build on and deliver the priority
of organisations have been part of a significant outcomes outlined in this document.
engagement programme, which has shaped
the strategy’s priorities, which broadly follow the 1.4
National Carers Strategy. This comprised of a Due to the changes that have taken place as a result
survey for carers, eight focus groups with carers, of the Covid-19 Pandemic since March 2020, the
and engagement with professionals who work with strategy has had to consider the new landscape
carers. A collaborative task and finish group, which for carers whilst balancing these with the long term
included carers, was established in June 2019 to ambitions of the strategy. Therefore this strategy
lead on the development of this Strategy. A full list has been updated by the task and finish group,
of task and finish group members is available in to consider these new issues and how they are
Appendix 2. influencing the strategic approach to supporting
carers in Merton. These issues are recorded
separately in boxes at the end of each priority
section, and will be addressed in the strategy’s
implementation plan.
8 Merton Carers Strategy 2021-26
2 | Introduction
2.1 2.3
Many people across the borough spend a large The National Carers Strategy defined a carer as
amount of time providing unpaid care for a family someone who spends a significant proportion of
member or friend, who would be unable to cope their time providing unpaid support to a family
without their help. Carers have a valuable role to play member, partner or friend who is ill, frail, disabled or
and it is widely acknowledged that carers contribute has mental health or substance misuse problems.
significantly to ensuring that the person they care for Many carers do not see themselves as carers, as
remains independent in their own home for longer. for them the caring relationship is simply part of
everyday normal life as a wife, husband, partner,
2.2 son, daughter, parent or friend. However, being
Carers don’t always choose or plan to be carers, recognised as a carer can provide access to
and can suddenly fall into the role of being a carer support, services, information and advice, which can
without any training, knowledge or preparation. help to make caring more manageable. For a list of
This is true now more than ever, with many who carer definitions, please refer to appendix 5.
haven’t previously provided care to a loved one now
taking on this role due to the new health risks and 2.4
lifestyle changes brought about by the Covid-19 There are services and support options available in
Pandemic. It is crucial that carers are identified and Merton for carers, although we recognise that there
feel supported with their caring role and their life are gaps and we need to work together to improve
alongside it, both in this time of crisis and going this. Therefore, this strategy sets out the vision for
forward. There will be a particular focus on carers Merton’s offer to adult carers and the actions that we
from BAME and underserved communities to ensure will take over the next five years in order to achieve
better outcomes for these residents. this. The implementation of this Strategy will also
align with the action plan for improving outcomes
for young carers, which are outlined in the Merton
Young Carers Multi-Agency Strategy.
Merton Carers Strategy 2021-26 9 3 | A Vision for Carers in Merton For carers in Merton to feel recognised, listened to and supported (socially, medically, emotionally and financially) in this vital role so they can live their life to the full alongside caring.
10 Merton Carers Strategy 2021-26
4 | Overview of Priorities
Identification
Recognition and
Contribution
A Life Merton Health and
Alongside Carers Wellbeing of
Caring Strategy Carers
Realise and
Release
PotentialMerton Carers Strategy 2021-26 11
5 | The Merton Story
5.1
As of 2019, Merton has a population of 210,4523 ■ 82% of carers in Merton live with the person
and an estimated 16,3274 unpaid carers. Carers UK they care for4.
estimates that 1 in 8 adults in the UK are carers,
which suggests that the figure in Merton could be ■ According to ONS census data, 5,493 of
higher than official figures suggest, therefore more Merton’s carers are from Black, Asian and
like 20,000 carers. minority Ethnic (BAME) backgrounds. This is
34% of the overall number of carers. Carers
from some BAME backgrounds are less likely
to access carers services compared with
■ Of the 16,327 carers, 1,452 are classed as white-British counterparts, this is particularly
‘Young Carers’ and are aged 0-24. 412 of true of individuals from Asian and ‘other
these Young Carers are below age 154. white’ (non-British or Irish) backgrounds.*
The national review6 published in June 2020
■ The majority (12,935) of Merton’s carers are highlighted that there is a disproportionate
of working age, with 9,280 in some form of impact of Covid-19 on BAME groups.
employment. 6% (2,980) of the total number
of carers are over 654.
*Based on 2018/19 new referral figures to Carers
■ In Merton, 75% of carers surveyed have Support Merton.
been caring for over 5 years, and 32% have
been caring for 20+ years4. Both of these
figures are over 5% higher than the London
average, and 10% higher than the average
for England.
■ Carers care for people with a range of
different support needs and very often can
care for someone who has more than one
condition. In Merton 34% of those cared
for have Dementia; 42% have a Physical
Disability; 22% have Sight or Hearing Loss;
38% have a Mental Health problem; 20%
have problems related to ageing; 24% have
a learning disability; 27% have a long-term
illness; 4% have a terminal illness; 3% have
an alcohol or drug dependency.5
3
https://data.london.gov.uk/dataset/housing-led-population-projections 6
“Beyond the data: Understanding the impact of COVID-19 on BAME groups”
4
https://www.nomisweb.co.uk/census/2011/local_characteristics (2020), PHE available at https://assets.publishing.service.gov.uk/government/
5
https://digital.nhs.uk/data-and-information/publications/statistical/adult- uploads/system/uploads/attachment_data/file/892376/COVID_stakeholder_
social-care-outcomes-framework-ascof/upcoming engagement_synthesis_beyond_the_data.pdf12 Merton Carers Strategy 2021-26
The Impact on Carers Nationally Since the Beginning of the Covid-19 Pandemic
Due to the Covid-19 Pandemic, Carers Week UK reported in June that the total number of carers in
the UK is likely to have grown by 50% since March 20201. This statistic will no doubt fluctuate due to
the changing nature of the infection rate of Covid-19, and as a result the restrictions that are removed
and imposed on how people can live their lives. Whilst we are learning about the local picture, national
research is emerging that shows:
■ 70% of carers were providing more care ■ Unpaid carers who started caring since the
during the outbreak; 81% were spending outbreak are more likely to be younger. 5%
more money, and 55% felt overwhelmed by were aged over 65, compared with 23% of
the outbreak2 unpaid carers who were already providing
care pre-outbreak1.
■ People new to caring are more likely to be
in paid work, and be a parent or guardian ■ It is unclear how long caring responsibilities
for someone under the age of 18: will continue for, for the new cohort of
carers.
■ Almost two thirds (62%) are in paid work
– 41% are working full time, and 21% ■ There is accumulating evidence to
working part time. These new unpaid suggest that cases of Covid-19 who
carers are 30% more likely to be in paid have experienced both mild and severe
work and these figures suggest that symptoms can experience long-term health
2.8 million extra workers are now juggling effects; Long Covid-19. This could have
work and unpaid care1. a significant impact on carers. In addition,
there could potentially be more people in a
■ 35% are a parent or guardian for someone caring role as a result of this.
under 18, which is significantly higher than
those who were caring already before the
crisis1.
Sources
1. https://www.carersuk.org/images/News_and_campaigns/Behind_Closed_Doors_2020/Caring_behind_closed_doors_April20_pages_web_final.pdf
2. https://www.carersweek.org/images/CW%202020%20Research%20Report%20WEB.pdfMerton Carers Strategy 2021-26 13
6 | Caring in Merton
6.1 6.3
Although providing care and support can be The Merton Health and Wellbeing Board recently
rewarding, we know that many carers struggle commissioned a study on the impact of the
at times. We also know that carers often put Covid-19 Pandemic on vulnerable groups in Merton,
the wellbeing of those they provide care for first, including carers. We will use the results of this study
meaning their own health and wellbeing issues can to inform the implementation of the Carers Strategy.
be ignored for longer.
6.4
6.2 The following quotes from carers in Merton capture
Two surveys7 completed by Merton’s carers have just a glimpse of issues carers have faced during the
helped us to identify the biggest issues carers face Covid-19 Pandemic:
as a result of their caring role:
How caring affects mental wellbeing:
■ “My daughter in supported living is really
63% say caring causing significant stress
missing her friends and the staff at her day
centre who she’s known for years.”
45% say being depressed as a result of their caring role
68% say caring role has negatively affected their ■ “Being in the same environment with my
emotional wellbeing husband 24 hours a day with less support
and any avenues to escape such as going
to work or being able to participate in leisure
activities has made me feel very isolated”.
How caring affects a life outside of caring:
Only 25% have as much social contact as they would like ■ “My son has lost his confidence and got
depressed since losing his volunteer role.”
88% say that caring has made career progression more
difficult ■ “During lockdown I was feeling very
emotional, exhausted and snappy. I used
to spend a lot of time crying due to being
How caring affects physical health: sleep deprived. Now I have had a carers
assessment and am receiving support I am
70% of carers’ physical health has been negatively affected
feeling better”.
due to caring role
■ “I can just about cope at the moment with
79% of carers feel tired as a result of caring
two days a week activity, but not in the longer
64% report loss of sleep term.”
20% say that caring made existing conditions worse ■ “It’s so hard to know what it’s safe to do at
the moment.”
7
https://digital.nhs.uk/data-and-information/data-collections-and-data- ■ “It’s hard to cope with all the extra worry on
sets/data-collections/social-care-user-surveys/social-care-carers-
top of all the usual caring duties.”
survey-2018-19, and Merton Carers Survey 201914 Merton Carers Strategy 2021-26
7 | Policy Context
7.1 7.3
The Care Act 2014, the Children and Families Act As part of a prevention work-stream, the Council is
2014, the National Carers Strategy 2008-2018, working alongside Merton Clinical Commissioning
the Carers Action Plan 2018-2020 and the NHS Group (CCG), Central London Community
Long Term Plan 2019 all make a significant shift Healthcare (CLCH), local voluntary community sector
in the approach to how carers are supported, organisations and Merton Health and Care Together
acknowledging the important contribution they on a number of prevention activities, all of which
make. These documents place Carers on the same are relevant to the Carers Strategy. These include
footing as the person they care for when it comes promoting prevention services in the Borough,
to accessing services they may need. This Strategy developing a ‘network of connectors’, ‘making every
has been developed in response to the needs of contact count’ through staff training, supporting staff
carers in Merton and the statutory requirements. For and providing leadership for Healthy Workplaces
a more detailed understanding regarding the Policy and embedding prevention in health and care
Context for this strategy, please refer to appendix 3. pathways, such as opportunities to access healthy
eating information or signposting to a service whilst
7.2 accessing another social care, health or housing
Merton has a number of strategies and plans that service.
are closely linked to the Carers Strategy, with aligned
priorities and a number of the same partners. The 7.4
key strategies we are working with are the Merton Other local strategic links to the Carers Strategy
Young Carers Multi-Agency Strategy and the include:
Health and Wellbeing Strategy 2019-24. It is
intended that the Carers Strategy and the Merton
Young Carers Strategy will be implemented together ■ The Special Educational Needs and/or
through a joint action plan, and progress updates Disabilities (SEND) Strategy 2020-2023
will be collectively provided to the Merton Health and
Wellbeing Board. ■ Merton Autism Strategy 2018-2023
■ South West London and St George’s Mental
Health Trust Strategy 2018-2023
■ Merton Dementia Action Alliance
■ Merton Local Outbreak Control Plan 2020
7.5
Full descriptions of some of these local strategies,
and how we are forming links between them and
the Carers Strategy 2020-2025, can be found in
Appendix 4.Our Priorities 15
p.15 p.19 p.23 p.27
Priority One: Priority Two: Priority Three: Priority Four:
Identification, Recognition, Health and Wellbeing Realise and Release A Life Alongside Caring
and Contribution of Carers Potential
8 | Priority One: Identification,
Recognition, and Contribution
8.1 ■ “It took me 5 years to access carers services.
As identified in the NHS Long Term Plan, carers are A carers assessment seemed to be an
twice as likely to suffer ill health as a result of caring, afterthought for the team treating my son”
and earlier, better identification of carers can ensure
that they get the support they require. The Long ■ “People don’t necessarily ask for support
Term Plan makes the commitment to continue to until things go wrong, services need to
identify and support carers, particularly those from reach out to make sure carers know what is
vulnerable communities. available and that there is an advantage to
being in the system.”
8.2
We aim to make sure that people who provide ■ “Work has to be done though schools and
support are identified as carers at the earliest GPs to identify carers.”
opportunity. This is so carers can be offered
appropriate information, advice and support, and ■ “For some of us, it takes 2/3 years from initial
access to services to help them in their caring role. concern to diagnosis. For all this time carers
We aim to create a system where carers feel listened are caring without recognition.”
to and, where appropriate, able to contribute to the
design and monitoring of services and in planning
individual care packages.
8.3.2
Identification, Recognition, and Contribution: Carers identifying themselves: Significant numbers
of people with caring responsibilities do not readily
8.3 identify themselves as carers. Carers told us that
What carers and people who work with them they took a while to identify as a carer, for a number
said: of reasons. For some, people do not want to
assume the responsibilities of being identified as a
8.3.1 carer. For some, they feel that this is just part of their
Identifying carers: Some people with caring family role. The concept of caring is assumed but
responsibilities are not identified as a carer until later not recognised in some families in ethnic minority
on in their caring journey. This can mean carers can communities. For example, in Urdu there is no direct
miss out on support, including emotional support translation for the work ‘carer’. Some carers told
and financial assistance to which they may be us that carers are not recognised by services at all
entitled. stages of their caring journey.16 Merton Carers Strategy 2021-26
■ “I didn’t realise how recognising myself as on benefits, finances and activities. In Merton, the
a carer would help, I wish I knew then what percentage of carers, who say they find it easy to
I know now; it would have really helped me access information about support has fallen since
emotionally.” 2012/13, to 58%, and is now below the comparator
group average. Services need to be promoted more
■ “Even when my daughter moved into widely across the Borough.
supported living, I was still her carer and I
have to continuously advocate for her.” 8.3.5
Listening to carers: There are areas of good
practice, where carers told us they feel listened to
by health and social care professionals and are able
8.3.3 to contribute where appropriate. However, carers
Carers assessments: There are clear benefits to also told us how they have to fight to get their voices
undergoing a carer’s assessment, but some carers heard by health and social care services and this
also told us they did not know what the assessment can be exhausting. There is scope to improve the
was, or how they could request one. Carers way services listen to carers and ensure consistency
responding to our survey, who have previously across Merton.
undergone a carer’s assessment, felt better informed
about the local services available to them and 8.3.6
were more likely to say that they know where to Valued carers services: Organisations that support
find appropriate information and advice. However, carers in the borough, are highly valued by many of
professionals stated that often carers can refuse an the carers that use these services.
assessment and think it is a test of how well they
provide care.
■ “Support groups and lessons put on by
Carers Support Merton are wonderful and
■ 81% of carers who have had a carer’s have helped me to change my outlook.”
assessment would know where to find
information and advice vs 56% who had not ■ “Carers support groups are a fantastic way
had a carers assessment to share best practice and provide support to
each other.”
■ 54% who have had a carer’s assessment felt
informed about local services vs 37% who
had not.
8.3.7
Support for family carers for under 18s: Family
carers told us there are only a few support groups
8.3.4 and activities specifically for them. Whilst carers
Raise awareness of Information and advice for in this group are able to attend support groups at
carers: Carers and professionals feel there is a lack Carers Support Merton and Kids First, family carers
of awareness of what carers are entitled to, such felt there were a lack of activities and opportunities.
as access to information and advice, specificallyOur Priorities 17
8.3.8 8.4.3
Carer contribution: Carers would like more Carers assessments: Work to ensure that people
opportunities to feel listened to when services and understand the benefits of having a carer’s
support are being planned with their loved one and assessment, with a view to increase the number of
would like to contribute to the design, monitoring carers having these assessments.
and re-provisioning of local services. This can
sometimes present challenges when the customer 8.4.4
chooses not to involve their carer. There are Information and advice for carers: Improve our
examples of good practice locally and we would like local information and advice offer to carers through a
to build on this. Carers thought the Triangle of Care8 range of channels including the digital offer and aim
in the Mental Health Trust was a good approach but to increase the local support available to carers.
needed to be available for more carers.
8.4.5
Listening to carers: The council, local NHS services
■ “Services work best when they listen to including those provided by the Mental Health Trust
carers, as we have an expert knowledge of will work in partnership, to make sure the views of
our loved one’s condition and their needs” carers are recognised and they have opportunities to
comment on the design and monitoring of services.
We will aim to make sure that people and their
carers have opportunities to share their views and
8.4. help shape local services.
Priority One: Identification, Recognition, and
Contribution 8.4.6
Valued carers services: We will raise the profile of
Strategy Outcomes: Valued Carers Services and promote services more
widely by sharing and promoting best practice and
8.4.1 sharing carers stories.
Identify carers: Promote the identification of carers
at the earliest possible stage in their caring journey; 8.4.7
this means working with partners, to identify and Raise awareness of information and advice for
then support people in their caring role. We will carers: Work to make sure that staff in universal
focus on ensuring carers can access support, even services, schools, GP surgeries, and other public
if a diagnosis is still being sought. and voluntary-sector providers understand the role
carers play and the support that is available to them.
8.4.2
Carers identifying themselves: Raise the profile 8.4.8
of carers across Merton and promote the benefits Support for family carers of under 18s: We aim to
to identifying and recognising yourself as a carer, ensure adult and children’s services work together
including specific actions to engage with harder to and take a whole family approach in identifying
reach groups and BAME communities. and supporting carers. Services need to adopt a
whole family approach to assessment, planning and
service provision which is more likely to result in
support that is sustainable.
8
https://www.swlstg.nhs.uk/publications/594-trust-strategy-2018-2023/file18 Merton Carers Strategy 2021-26
8.4.9
Carer contribution: We will work with partners professionals. We will ensure that more carers of
across the health and social care sector to make people with mental health issues have access to
sure carers are able to share their views, where a ‘Triangle of Care’, key principles that support
appropriate, on individual care packages for the the carer role, whilst contributing to collaboration
cared for person, and through monitoring and between professional, service user and carer.
reviewing of services and training and support of
How is the Covid-19 Pandemic Currently Influencing Priority One: Identification,
Recognition, and Contribution?
Raise Awareness of Information and Advice for Carers:
■ With such a large increase in carers, it is particularly important that we make sure they can identify
as carers and receive the necessary information and advice to ensure the best outcomes for them
and their cared for person.
■ A decrease in engagement with statutory services means that opportunities to identify carers are
potentially reduced.
■ Throughout the Pandemic, Adult Social Care and Mental Health Trust staff worked hard to make
regular contact via telephone to provide information, advice and reassurance to carers. We will
need to consider how carers can access all the services they need.
■ Voluntary Sector organisations reshaped their service offer to provide online support and
telephone information, advice and assessments to carers. This supported a lot of carers, but also
highlighted digital inequality.
Lack of Opportunities for Family Carers for Under 18s:
■ It should be noted that people providing care since the Covid-19 Pandemic began are more likely
to have children under the age of 181. This may have been due to the closure of schools and
colleges, resulting in a higher number of dual carers.
Listening to Carers:
■ It is really important for carers’ views to feed into plans for both the recovery of services, and any
new ones as we learn to live with Covid-19.
Sources
1. https://www.carersweek.org/images/CW 2020 Research Report WEB.pdfOur Priorities 19
9 | Priority Two: Health and Wellbeing
of Carers
9.1
Carers can experience a range of health issues as a Caring for a loved one can have a physical and
result of their caring role. A key local policy for this emotional impact on the carer; 70% of carers told us
priority is the Health and Wellbeing Strategy 2019- their physical health has deteriorated as a result of
2024, which not only has corresponding outcomes their caring role and 67% said the same about their
but also ways of working such as tackling health emotional health.
inequalities, and focusing on prevention and early
intervention. 9.4.4
Health services and carers: Some carers told us
9.2 that they often don’t have time to address their own
We know caring can be rewarding, but it can also health concerns and that they struggle to fit in health
make managing one’s own health and wellbeing appointments for themselves due to a lack of time
more difficult. Therefore, we aim to support carers away from caring.
to manage their own health and wellbeing and
make sure people with caring responsibilities are
able to remain as physically and emotionally well as ■ “There are many reasons carers go without
possible. treatment; recovery times, being unable to
find an appointment at a suitable time, and
9.4 having no one to look after the cared for
Priority Two: Health and Wellbeing of Carers person are all reasons why carers don’t get
the help they need.”
What carers and people who work with them
said: ■ “If an operation or medical procedure gets
rescheduled last minute, everything falls
9.4.1 through!”
Planning for the future: Carers worry about the
future, when they are no longer able to provide care
and support and want to be able to plan for this.
9.4.5
9.4.2 Health and wellbeing activities for carers: Health
Emergency planning for carers: Carers worry about and wellbeing classes for carers are well regarded by
what will happen to the person they care for in the those who use them. However, carers told us that
event of an emergency. the main factors that prevent them from exercising,
eating healthily and looking after their emotional
9.4.3 wellbeing are time, cost, and existing health issues.
Health and wellbeing of carers: Caring is often
rewarding, with 70% of carers surveyed agreeing
or strongly agreeing with this; but it can also be ■ “Where is the time to eat well and exercise
stressful too, with 98% of those surveyed agreeing when you’re caring all day and lacking sleep
or strongly agreeing with this. at night.”20 Merton Carers Strategy 2021-26
9.4.6 9.5.2
Council processes and carers: Carers told us that Carers emergency plans: We aim to have a plan
navigating the council’s processes and pathways in place for the cared for person in the event of an
can cause unnecessary stress. emergency. This could be in the form of a carer’s
card. We will also work with partners to implement
more widely Co-ordinate My Care9 and My CMC10 to
■ “The amount of time spent interacting with consider the wishes of the cared for and their carers
the system is mentally draining […] The way in the development of urgent treatment plans.
the system works puts an extra-load on us!”
9.5.3
■ “Merton’s systems are time consuming, Health and wellbeing of carers: The Council,
especially when something goes wrong.” Clinical Commissioning Group, Mental Health
Trust and other community connectors will work
■ “Why can’t the different systems not talk together to make sure that carers are supported to
to each other? We have to give the same access the universal services they need, in a way
information and evidence several times.” that is accessible to them. We aim to improve the
digital offer for carers in Merton as a mechanism
for improving access to health and wellbeing
information. We will also work with partners towards
9.4.7 making sure that carers do not have to share the
Life after caring: Former carers can find it hard same information several times with professionals.
to adjust to changes in their life when their caring
role ends. It may be that the person they care for 9.5.4
has moved on or has died. Whilst there are some Health services and carers: We aim to make it
services and courses to support former carers, it is easier for carers to manage the appointments and
important to acknowledge the impact this has on a wellbeing of the person they are caring for and
person’s health and wellbeing. themselves.
9.5 9.5.5
Priority Two: Health and Wellbeing of Carers: Health and wellbeing activities for carers: We will
Strategy Outcomes look at how carers can be provided with affordable,
flexible, and inclusive opportunities to take part in
9.5.1 activities, which contribute towards good health and
Plan for the future: We aim to support carers wellbeing, such as Merton Uplift workshops and
to make a plan for the future. This will include support, fitness or mindfulness classes. This will
supporting carers to manage wills and power of involve working with partners such as local leisure
attorney; it also means supporting carers to have centres, colleges, and community connectors.
provisions in place for if they are no longer able to
provide care.
9
https://www.coordinatemycare.co.uk/
10
https://www.coordinatemycare.co.uk/cmc-videos/20-mycmc/Our Priorities 21
9.5.6 9.5.7
Council processes and carers: We will review Life after caring: We will review support and
council processes, aiming to make these more services on offer to former carers and recognise the
efficient and easier to use, minimising the stress valuable contribution that they have to offer.
caused to carers trying to navigate the system.
How is the Covid-19 Pandemic Currently Influencing Priority Two: Health and
Wellbeing of Carers?
Emergency Planning for Carers:
■ The Covid-19 Pandemic has increased concern that stretched services would be unable to cover
the gaps in care caused by a carer’s illness or self-isolation.
Health and Wellbeing:
■ The Covid-19 Pandemic has increased the loved one in a care home, it has been
pressure on the health and wellbeing of very distressing for carers who have been
carers. Not only has the lack of respite from unable to see people living in residential
caring increased the possibility of burnout, and nursing care.
but the type of care being provided is also
more likely to include emotional support for ■ Analysis of South West London Primary
a loved one as routines have changed. In Care Covid-19 Risk Survey, July 2020,
Carers UK April 2020 research, one third recognised the important role that informal
of carers felt they were unable to look after carers play and identified carers as a group
their own health and wellbeing1. of concern at this time.
■ Online wellbeing activities that Carers ■ The Government has announced its
Support Merton have provided during roadmap out of lockdown. However,
lockdown have had high levels of uptake. measures are likely to still include social
distancing and restrictive access, which
■ A survey carried out by Alzheimer’s UK inevitably will have an impact on carers.
stated that 95% of carers reported that the
increased caring responsibilities due to the ■ On a positive note, Carers will be prioritised
Covid-19 Pandemic has had an impact on to be offered Covid-19 vaccinations. This
their mental or physical health2. could increase the numbers of carers
identifying themselves and needing
■ Despite the Government now announcing support, so services will need to ensure
that one person will be able to visit their that they have capacity to support this.
Continued overleaf...22 Merton Carers Strategy 2021-26
How is the Covid-19 Pandemic Currently Influencing Priority Two: Health and
Wellbeing of Carers? Continued.
Duration and Intensity of Care:
■ There are a number of reasons why 70% of ■ 76% of carers responding to a survey by
carers have increased the amount of care Alzheimer’s Society, reported an increase
they provide. For 35% of these carers it in their caring responsibilities due to the
is due to local day services closing, whilst worsening dementia symptoms of the
10% of the overall figure say that social person they care for, over the period of
and health care staff have decreased the lockdown2.
amount of care they provide1.
Accessing Services:
■ The South West London CCG carried out ■ Availability and access to social care
engagement from March-August 2020. services and short breaks has been limited
Results suggests that people are hindered through the pandemic, increasing the
from accessing health services due to level of support the carer provides which
concern about burdening the NHS, fear has caused additional strain. As we move
of contracting the Covid-19 Pandemic towards recovery, we will need to ensure
overriding other health concerns; lack of that services that support carers to have a
clarity about what is happening to services break are more widely available.
they usually use; and digital exclusion.
■ Carers Support Merton has seen an
■ Coordinate My Care (CMC) is an online increase in concern regarding wellbeing
urgent personalised care plan that enables across all Carers Assessments since the
the wishes and choice of an individual beginning of the pandemic.
around their health and social care to be
documented and visible to health services.
All partners are working together to help
increase awareness and understanding of
the benefits of Co-ordinate My Care.
Sources:
1. https://www.carersuk.org/images/News_and_campaigns/Behind_Closed_Doors_2020/Caring_behind_closed_doors_April20_pages_web_final.pdf
2. https://www.alzheimers.org.uk/sites/default/files/2020-09/Worst-hit-Dementia-during-coronavirus-report.pdfOur Priorities 23
10 | Priority Three:
Realise and Release Potential
10.1 10.3
People who provide care to a loved one often Priority Three: Realise and Release Potential
face multiple challenges; these challenges can
make reaching employment and educational What carers and people who work with them
potential more difficult. We also know that many said:
working carers experience substantial challenges
in balancing employment and their caring 10.3.1
responsibilities. Changing demographics and an Carer friendly work environment: Carers feel being
ageing population mean that 3 in 5 people will end in employment has a positive effect on wellbeing,
up caring for someone at some point in their lives. as well as providing them with a greater sense
The Department of Health and Social Care has been of identity. However, any job needs to have carer
working, as part of the Carers Action Plan 2018- friendly work-practices such as flexible working,
202011 to raise the profile of carers with employers home working, and time off to attend appointments
to enable carers to continue to work alongside their with the cared for person.
caring role.
10.3.2
10.2 Financial hardship for carers: Despite Merton as
This priority is about supporting carers to start or a whole being a less deprived London Borough,
maintain employment, volunteering, training, and carers who live in the east of the borough are more
learning if they wish to do so. We will look to gain likely to have a lower socio-economic status than
a better understanding of carers’ needs and make Carers who live in the west of the borough12. Carers
sure they have opportunities to gain skills, which who work in lower paid roles face additional financial
can help them to reach their employment and hardship; therefore, it is important for carers to know
educational potential so that they are not forced into what benefits and financial support they are entitled
financial hardship by their caring role. to. There are also significant financial implications
for people if they are not or no longer able to work.
Some people can lose their income immediately
if they suddenly need care or are looking after
someone that needs care. Therefore, no matter
what someone’s financial circumstances are, people
can experience extremely difficult and complicated
financial hardship.
11
https://assets.publishing.service.gov.uk/government/uploads/system/ 12
https://www.merton.gov.uk/assets/Documents/www2/Merton%20Story%20
uploads/attachment_data/file/713781/carers-action-plan-2018-2020.pdf FINAL_June_2018.pdf24 Merton Carers Strategy 2021-26
10.3.3 ■ “There are courses carers can do, but if you
Carer friendly work practices: The majority of carers want something more skilled it costs a lot!”
surveyed, who are in employment, told us that
their employer was accommodating of their caring ■ “I would like to access Adult Ed courses to
responsibilities. However, we understand that carers progress my career and learning, but these
can face difficulties with their employer. Carers in are very expensive”
Merton have had to reduce their hours, compromise
their position, or give up employment.
10.3.4 10.3.6
Career progression for carers: Carers surveyed told Digital skills for carers: Carers told us they would
us that career progression has been made more appreciate more opportunities to learn IT and
difficult because of their caring responsibilities. 1 digital skills. A report by Carers UK and the Good
in 6 carers give up work or reduce their hours to Things Foundation (previously known as the Tinder
care and many of these employees will be the most Foundation) concluded that poor knowledge of and
valuable staff, the 45-64 year-olds at the peak of access to IT is a key issue for carers. With more
their careers13. organisations moving over to digital platforms, there
is an increasing need to support carers to develop
the necessary skills they need to access services.
■ “I had to leave my job two-years ago, now
I’ve gone back but in a far lower position in a
sector I don’t want to be in” ■ In Merton, 660 known carers do not have
access to the internet or email. This affects
■ 78% of carers feel their caring role has made not only their ability to find work, but also
career progression more difficult for them. provides another barrier to accessing
information and advice; and staying
connected.
10.3.5 ■ “IT training is essential for many carers,
Learning and development for carers: Carers who especially those that have been out of work
are not in employment or education said that they for a number of years and are behind in this.”
would like to undertake training and learning to
improve the skills they have. However, some find the
opportunities unaffordable and inaccessible.
10.3.7
Volunteering for carers: There is appetite amongst
carers to participate in volunteering. 14% of carers
surveyed would like to volunteer more.
13
https://www.employersforcarers.org/about-usOur Priorities 25
■ “Volunteering can be valuable but many 10.4.4
volunteering positions require a reference; it Career progression for carers: We will look at
is very hard for some carers to get references how we can ensure carers are able to access to
due to not having worked for a number of affordable training and learning, which can help them
years or being socially isolated.” gain the skills they need to reach their employment
potential.
10.4.5
10.4 Learning and development for carers: We aim
Priority Three: Realise and Release Potential: to review affordable learning and development
Strategy Outcomes: opportunities for carers. Adult Social Care will also
review the Carer’s Discretionary Grant, to see how
10.4.1 it can be used more creatively to support carers,
Carer friendly work environment: By recognising which will include:
the needs of carers, employers can hold on to
experienced staff and reap the rewards of creating
a supportive working environment for carers. The ■ Technology to help improve skills and stay
council and NHS organisations, two of the largest connected
employers in the borough, aim to review workplace
practices with their organisations and ensure carers ■ Short breaks
within these organisations feel supported at work.
■ Assistive technology to support cared for
10.4.2 safety and carer reassurance.
Financial hardship for carers: We need to
acknowledge the importance that demographics ■ Learning and development opportunities
play in realising and releasing potential for carers
in Merton. Therefore, we will work with partners to
identify what actions would need to be taken to
‘bridge the gap’ between the east and west of the 10.4.6
borough. Digital skills for carers: We will explore ways to
support carers to gain IT and digital skills. This will
10.4.3 mean carers are better able to stay connected,
Carer friendly work practices: We aim to promote access information and advice, and gain the
carer-friendly work practices to employers across necessary skills for the workplace.
the borough. This could mean working with local
employers and the Chamber of Commerce to 10.4.7
develop a set of standards for which recognition can Volunteering for carers: We want to make
be awarded, if carer-friendly practices are adopted. sure carers are adequately supported to take
advantages of opportunities to improve their skills
and knowledge, including volunteering placements.
This links to the Merton Sustainable Communities
Plan 2020-2025, which aims to remove barriers to
volunteering across the borough.26 Merton Carers Strategy 2021-26
How is the Covid-19 Pandemic Currently Influencing Priority Three: Realise and
Release Potential?
Work:
■ People providing unpaid care since the start of the Coronavirus outbreak are more likely to be in
paid work, and in total 26% of all workers are juggling work and unpaid care2.
■ 1,230 respondents who indicated they were in paid work before the crisis were asked for details
about their current working situation. Almost a fifth (17%) reported either having lost or given up their
job or being unable to work because of the social distancing rules1.
■ More opportunities for flexible working could improve the work/life balance situation for some carers.
Finance:
■ According to research this year, the vast majority of carers have seen an increase in household
costs - 81% said they were spending more, and the biggest reason for an increase was spending
more on food1.
Learning and development:
■ Throughout the Covid-19 Pandemic, a number of resources have been developed online to provide
support including courses via Merton Adult Learning, the Recovery College, and Department of
Work and Pensions. However, not all carers are able to access online learning resources.
Sources:
1. https://www.carersuk.org/images/News_and_campaigns/Behind_Closed_Doors_2020/Caring_behind_closed_doors_April20_pages_web_final.pdf
2. https://www.alzheimers.org.uk/sites/default/files/2020-09/Worst-hit-Dementia-during-coronavirus-report.pdfOur Priorities 27
11 | Priority Four: A Life Alongside Caring
11.1 11.3.2
The Care Act 2014 has led to a significant shift in Unplanned breaks from caring: Carers told us
approach to the way that carers can expect to be of their frustration and worry that any break from
supported by the Local Authority with promoting caring must be planned in advance, meaning that
wellbeing being at the heart of the legislation. plans can’t be made in the short term.
11.2
Having a strong social network is important for ■ “I want something that will allow me to do
emotional wellbeing, but it is also important for something in the spur of the moment”.
our physical health. With that in mind, this priority
focuses on ensuring carers are supported to have ■ “I worry about needing support in an
a family, community, and social life alongside their emergency and what would happen”
caring role; this links to the Promoting Mental Health
& Wellbeing priority area of the Health and Wellbeing
Strategy, which aims to reduce loneliness and
increase social connectedness. 11.3.3
Planned breaks for caring: Carers told us they
were unable to plan holidays in advance, because
Merton’s current offer means respite cannot be
11.3 confirmed on an annual basis and there is no way of
Priority Four: A Life Alongside Caring having an allocation (with the exception of Learning
Disability bed based respite).
What carers and people who work with them
said: 11.3.4
Carers connected with family and friends: The
11.3.1 vast majority of carers surveyed (85%) feel socially
A break from caring: Having a break was a recurring isolated as a result of their caring responsibilities.
theme throughout the engagement. 72% of carers 29% of Carers surveyed felt dissatisfied with the
surveyed were dissatisfied with the amount of amount of time they spend with their family and 57%
breaks they were able to have. Carers also told of carers surveyed were dissatisfied with the amount
us that there should be a greater variety of breaks of time they spent with friends.
available to them.
11.3.5
Carers connected with others: In the focus group
discussions, many carers told us they feel they
would benefit from befrienders, peer support and
other forms of volunteer support.28 Merton Carers Strategy 2021-26
11.3.6 11.4
A quality service for both cared for and carer: Priority Four: A Life Alongside Caring: Strategy
It was clear that the enjoyment of the cared for Outcomes:
person, whilst the carer was taking a break without
their loved one, was also important. 11.4.1
A break from caring: We will work towards making
sure support in the community provides a variety of
■ “Both of us have to enjoy the respite. I can’t options for customers and carers.
relax unless I know [the cared for person] is
having fun and being looked after” 11.4.2
Unplanned breaks from caring: We will work with
all partners with the aim to support carers when an
unplanned break is needed.
11.3.7
A break with a loved one: Some carers told us that 11.4.3
a break does not necessarily have to be time away Planned breaks for caring: We will consider the
from the cared for person; it could be an activity they council’s processes relating to respite, so that carers
can both enjoy together. can plan time away in advance.
11.4.4
■ “A break could be something that we do Carers connected with family and friends: Review
together; an extra pair of hands and eyes to the way we use and distribute Carers Discretionary
help look after [the cared for person] would Grants, with a view to provide carers with greater
help me to relax.” flexibility with how they use these to support
themselves.
■ “I used to attend ‘Stay and Play’ activities
with the cared for person. They were 11.4.5
great and you could meet other carers in Carers connected with others: Review the current
similar situations. Unfortunately, these were offer relating to befriending and peer support for
stopped.” carers, with a view to strengthening the offer. We
will also review volunteering support to carers in
■ “It’s great coming to this support group. I get Merton. Continue to promote the carers support
two hours to relax and talk to people whilst groups available in the borough, ensuring those who
my husband enjoys taking part in activities in are new to caring are aware of the support services
another room. When he has a good time, I available to them.
can relax and have fun myself.”Our Priorities 29
11.4.6 11.4.7
A quality service for both cared for and carer: A break with a loved one: We aim to ensure there
Make sure the views of carers are heard when is a range of options exist for carers to take a break,
reviewing and making changes to current services including activities that can be done with the cared
that support carers in Merton. We aim to ensure for person.
there are services available that can give the carer a
break whilst the cared for is engaged in a meaningful
activity.
How is the Covid-19 Pandemic Currently Influencing Priority Four: A Life
Alongside Caring?
Carers concerns around current risk:
■ Carers have reported feeling worried about the current risks of Covid-19. Lots of carers have been
self-isolating to support a loved one that has been shielding and have experienced isolation and
have felt the additional strain of an increased level of caring.
■ Carers have said they feel increasingly concerned about the future and what support and services
will be available to support them with their caring role1.
■ As we move towards re-opening of services, careful consideration needs to be given to supporting
carers that have been isolated and providing additional support to their loved ones for an extended
period of time. We will need to understand and respond to the impact of this.
Digital Accessibility:
■ Those without digital access will have been unable to access activities and support to the same
extent as other carers. It is therefore important to increase digital accessibility so all carers are able
to explore the wide range of options available to them.
Declining independence/skills development for cared for person due to lockdown:
■ There is concern that the independence, and related skills, that a cared for person previously had
will be lost over periods of shielding. This could then cause extra strain for carers, such as limiting
their ability to go and meet friends.
Continued overleaf...
Sources:
1. https://www.carersuk.org/images/News_and_campaigns/Behind_Closed_Doors_2020/Caring_behind_closed_doors_April20_pages_web_final.pdf30 Merton Carers Strategy 2021-26
How is the Covid-19 Pandemic Currently Influencing Priority Four: A Life
Alongside Caring? Continued.
Short Breaks:
■ Availability and access to short breaks has been affected by the Covid-19 Pandemic.
■ When asked about what the biggest challenges carers face are, ‘not being able to take time away
from caring’ was selected by 66% of respondents2.
Awareness of the role of carers has increased:
■ Awareness of unpaid carers is higher since the outbreak of coronavirus according to the general
public. Half (48%) of those who had never been a carer said they were either more aware or much
more aware of unpaid carers2.
Sources:
2. https://www.carersweek.org/images/CW 2020 Research Report WEB.pdfYou can also read
